2004, 06-10 Permit App: BLD-04-04574 Mechanical Fixturess ary, or
ika�ne
;0OValley
Project Address:
Owner:
Mailing Address:
Contractor:
Mailing Address:
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS,4CALL (591688-0054
Permit Use: W e;,ri _ �y cir
icense #:
Phone (Daytime Contact):
City State Zip Code
Phone #:
City
State Zip Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF
UNITS X
COST =
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00 =
2
FUEL BURNING APPLIANCE
More than 100,000
X
$19.00 =
3
UNLISTED APPLIANCE Additional Fee
Equal to or less than 400,000
X
$50.00 -
4
UNLISTED APPLIANCE Additional Fee
More than 400,000
X
$100.00 =
5
USED APPLIANCE (WSEC min. AFUE
ratin
E uat to or less than 400,000
X
$50.00 =
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
$100.00 =
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00 =
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00 =
9
BOILERIREFRIGERATION
501 - 1,000M BTU
X
$39.00 =
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00 =
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00 =
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00 =
13
RANGE
X
$10.00 =
14
DRYER
X
$10.00 =
15
FUEL BURNING WATER HEATER
X
$10.00 =
16
MISC. FUEL BURNING APPLIANCE
X
$10.00 =
17
GAS PIPING each ouUet
X
$1.00 =
16
DUCT SYSTEMS
X
$10.00 =
19
VENTILATING FANS
X
$10.00 =
20
1 AIR HANDLER DOES NOT include ducting)
Equal to or less than 10,000 CFM
X 1
$12.00 =
21
AIR HANDLER DOES NOT include ducting)
Greater than 10,000 CFM
X
$19.00 =
22
EVAPORATIVE COOLERS
X
$10.00 =
23
TYPE t HOOD
X
$50.00 =
24
TYPE It HOOD
X
$10.00 =
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00 =
26
AIR CONDITIONER
3-15 TON
X
$20.00 =
27
1 AIR CONDITIONER
15-30 TON
X
$25.00 =
28
AIR CONDITIONER
30-50 TON
X
$35.00 =
29
AIR CONDITIONER
More than 50 TON
X
$60.00 =
30
LPG STORAGE TANK
X
$10.00 =
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
32
WOOD STOVE- FREE STANDING
X
$25.00 =
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
$35.00
AUTHORIZED SIGNATURE: